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Disabilities in American Society

by: Dr. Natalie Yost

Disabilities in American Society HSC 3559

Marketplace > University of Central Florida > Health Sciences > HSC 3559 > Disabilities in American Society
Dr. Natalie Yost
University of Central Florida
GPA 3.51

Debra Edgar

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Debra Edgar
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This 12 page Class Notes was uploaded by Dr. Natalie Yost on Thursday October 22, 2015. The Class Notes belongs to HSC 3559 at University of Central Florida taught by Debra Edgar in Fall. Since its upload, it has received 29 views. For similar materials see /class/227529/hsc-3559-university-of-central-florida in Health Sciences at University of Central Florida.

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Date Created: 10/22/15
1 De nition A Definitions Dea zess and hard of hearing have been terms used often inaccurately to describe a wide variety of hearing loss A hearing loss may be de ned according to the degree of loss by assessing a person s sensitivity to sound intensity and sound frequency 1 Sound intensity loudness is measured by units known as decibels 2 Sound frequency pitch is measured using hertz units 3 Deafness and Hard of Hearing The terms deaf and hard of hearing are commonly used to describe the severity of the hearing loss a A person who is deaf loss of 90 db or greater typically has profound or total loss of auditory sensitivity and little if any auditory perception The primary information input is through vision39 speech is not understood through the ear A person who is hard of hearing has partial or residual hearing generally with the use of a hearing aid that is suf cient to process language through the ear Age of Onset The age of onset of a hearing loss whether at birth congenital or during life is crucial in determining the type and extent of interventions necessary to minimize the effects of the loss A prelingual loss occurs prior to two years of age or before speech development A hearing loss that occurs before language has developed is more problematic especially in the areas of communication and social adaptation a A postlingual loss can occur at any age following speech development Anatomical Site of the Loss The two primary types of hearing loss based on anatomical site are peripheral and central auditory problems There are three types of peripheral hearing losses i Conductive b hearing losses result from poor conduction of sound along passages leading to the inner ear The effect of a conductive hearing loss is a reduction or loss of loudness ii Senson39neural hearing losses are the result of an abnormal sense organ or a damaged auditory nerve Sound is distorted thus affecting the clarity of human speech iii Mxed hearing loss is a combination of conductive and sensorineural problems a A central auditory disorder is not a loss in the ability to hear but a disorder of symbolic processes including auditory perception discrimination comprehension of sound and expressive and receptive language development B Classi cation A hearing loss may be classi ed according to the severity of the condition including insignificant mild hard of hearing moderate hard of hearing severe hard of hearing and deaf and profound deaf These systems suggest parameters for measuring a physical defect in auditory function They do not re ect the capabilities background or experiences of the individuals and therefore should be used with caution II Prevalence Hearing loss gets worse over time and dramatically increases with age A Estimates of hearing loss in the United States go as high as 28 million people or 1 of the total population Of this 28 million 1 million are deaf and 11 million have significant and irreversible hearing loss Only 5 of people with hearing losses are under the age of 17 while over 43 are over the age of 65 For the iPod generation the trouble could be worse More than twenty two American adults own an iPod or other digital music player and studies show that sustained listening even at moderate volume can cause serious harm Read the following article Music making fans deaf How the ipod generation may be losing its hearing without even knowing it Ringen 2006 Men are more likely to experience hearing loss Caucasians are over represented and the prevalence of hearing loss decreases as family income and education increase D The US Department of Education has reported that approximately 71964 of the students labeled as disabled who receive specialized services in public schools are hard of hearing or deaf Thirtyeight percent of the 71964 thousand students served by special education are served in general education classrooms for the majority of the school day Less than 16 of students with hearing impairments are served in day or residential schools for the deaf III Causation amp Characteristics A hearing loss is classified as congenital or acquired Congenital Factors Heredity w 0 loss Two hundred types of deafness have been linked to heredity but the cause of 33 of all prelingual hearing loss remains unknown i One of the most common diseases that affects the sense of hearing is otosclerosis People with otosclerosis suffer from highpitched throbbing or ringing sounds known as tinnitus a condition associated with disease of the inner ear a Prenatal disease The major cause of nongenetic congenital deafness is infection39 rubella congenital cytomegalovirus and congenital toxoplasmosisare the most common i Factors associated with a congenital sensorineural hearing loss include maternal Rhfactor incompatibility the use of ototoXic drugs maternal chicken pOX congenital syphilis anoXia and birth trauma ii A condition known as atresia is a major cause of congenital conductive disorders Acquired FactorsConditions acquired later in life also can result in a hearing Intelligence Postnatal DiseaseMeasles mumps in uenza typhoid fever scarlet fever and meningitis are associated with a hearing loss Otitis media also can result from severe colds that spread from the eustachian tube to the middle ear and it is the most common cause of conductive hearing loss in younger children a Environmental factorsExtreme changes in air pressure caused by explosions physical abuse of the cranial area foreign objects in the ear and loud noise are associated with hearing loss Occupational noise is now the leading cause of sensorineural hearing loss Other factors include degenerative processes in the ear that may be caused by aging cerebral hemorrhages allergies and intercranial tumors A Characteristics Although research is inconclusive as a group children who are deaf have an IQ distribution similar to that of hearing children a Intellectual development for people with a hearing loss is more a function of language development than cognitive ability Speech and English Language Skills Speech and language skills are the areas of development most severely affected for people with a hearing loss a Children with a hearing loss develop speech at a slower pace than their peers and thus are at a greater risk for emotional dif culties and isolation but the effects vary widely b The majority of people with a hearing loss are able to use speech as the primary mode for language acquisition Educational Achievement The educational achievement of students with a hearing loss may be signi cantly delayed in comparison to that of their hearing peers a Reading is the academic area most negatively affected for students with a hearing loss Social Development Adjustment to the Hearing World People with a hearing loss receive a reduced amount of auditory information As a result children who are deaf experience a different world than hearing children and this affects their psychological development The Deaf Culture The Deaf culture provides an environment where people with hearing impairments can develop a sense of belonging and pride The language of the deaf community is sign language which is a combination of signs gestures and interactive customs It is a separate language with its own grammatical structure a Many people marry within the deaf community and pass on its heritage to their children Hearing people are welcomed within the Deaf community but are seldom fully accepted IV Interdisciplinary Educational Services and Approaches Teaching communication skills Four common approaches are used to teach communication skills to students with a hearing loss No single method or collection of methods can meet the individual needs of all children with a hearing loss The auditory approach emphasizes the use of ampli ed sound aid and residual hearing to develop oral communication skills The auditory approach has nine basic principles Detecting hearing loss as soon as possible a Pursuing interventions promptly U 0 Q h i Providing parents with information concerning the hearing loss and options available Integrating listening into development of communication and social skills Onetoone teaching of verbalauditory development Supporting self monitoring of intelligibility of speech Using developmental patterns in natural communication settings Continual assessment and modi cation of programmatic structure Providing support in inclusive settings The auditory approach uses a variety of electroacoustic devices to enhance residual hearing The oral approach emphasizes the use of amplified sound and residual hearing but also may employ lipreading reading and writing motokinesthetic speech training feeling an individual s face and reproducing breath and voice patterns and speechreading understanding another s speech by watching lip movement and body and facial gestures Some organizations argue in favor of the oral approach because Most children with a hearing loss have useful residual hearing a b 90 When properly aided children with a hearing loss can detect most if not all of the speech spectrum Technology can enable a child to develop speech through the auditory channel Hearing amplification should occur as early as possible If hearing is not accessed during the years critical to language learning a child s ability to use acoustic input Will deteriorate Parents in auditoryverbal programs do not have to learn sign language or cued speech More than 90 of parents of children with a hearing loss have normal hearing The manual approach stresses the use of sign languages a systematic and complex combination of hand movements that communicate whole words and complete thoughts rather than single letters of the alphabet and sign systems an attempt to create a visual equivalent of oral language through manual gestures in teaching children who are deaf to communicate American Sign Language ASL is a language with its own grammatical structure while signage systems reproduce the spoken word in manual form a Advocates of a bilingualbicultural approach suggest that instruction be required in Which the child s primary language is ASL The total communication philosophy holds that the simultaneous presentation of signs and speech will enhance each individual s opportunity to understand and use both systems more effectively The total communication approach involves the simultaneous presentation of signs and speech and includes the use of residual hearing ampli cation lipreading speech training reading and writing in combination with manual systems a Cued speech facilitates the development of oral communication by combining eight different hand signals in different areas under the chin that provide information about sounds that are not identifiable through speechreading A Assistive TechnologyEducational and leisure time opportunities for people with a hearing loss are expanding through technological advances Closedcaptioned television translates the dialogue from a television program into captions subtitles that are broadcast on the television screen Software is available in a variety of academic subjects and innovative instructional supports such as CPrint which provides real time translation of the spoken word Interactive videodisk allows for interactive instruction that can have the student determine the pace Perhaps most importantly the Internet and websites have provided people with hearing impairments with access to information visually as well as email chat rooms and a myriad of other resources Telecommunication devices text telephones TT for the deaf send receive and print messages through thousands of stations located across the United States The teletypewriter and printer TTY allow people who are deaf to communicate by phone using a typewriter printer and modem Computer software can now turn a personal computer into a TTY Healthcare and Social Services Health CareMedicine plays a major role in the prevention early detection and remediation of a hearing loss Several specialists are integrally involved in the medical assessment and intervention process The geneticist is concerned with preventing hearing losses through family counseling and prenatal screening The role of the pediatrician or family practitioner is to be alert to any symptoms that indicate potential sensory loss and to refer the family to an appropriate hearing specialist The otologist is the medical specialist who is concerned with the hearing organ and its diseases A widely used surgical procedure is the cochlear implant where an electronic device is placed under the skin behind the ear and provides a useful sense of sound a Over 50 000 people worldwide have had the procedure half children and half adults It has been suggested that children from 18 months to 17 years of age are appropriate candidates if they meet certain criteria Some view the implants as a direct attack on the values and heritage of the Deaf culture while others view the implants as medical miracles U 0 An audiometric evaluation is conducted by an audiologist to measure the degree of an individual s hearing loss An otologist is a medical specialist concerned with the hearing organ and its diseases a The audiologist is concerned with the functional impact of hearing loss on an individual A A prominent organization is the Alexander Graham Bell Association for the Deaf which advocates for the inclusion of individuals with hearing loss in the social mainstream I The Visual Process A The physical components of the vision system include the following 1 The eye is connected to the visual center in the brain the visual L WM kl cortex The optic nerve connects the eye to the visual center The cornea is the external covering of the eye that bends or refracts light rays The pupil is the opening in the iris and controls the amount of light entering the eye The iris consists of tissues and muscles whose function is to adjust the size of the pupil 6 The lens bends light rays to strike the retina directly 7 The retina consists of lightsensitive cells that transmit the image to the brain by means of the optic nerve B The visual process although complex helps us to gain information beyond the range of other senses while also helping us to integrate the information acquired primarily through hearing touch smell and taste II De nitions and Classi cation Blindness 1 Legal blindness is visual acuity of 20200 or worse in the best eye With best correction as measured on the Snellen chart or a visual eld of 20 or less 2 Visual acuity is indicated by the use of an index that refers to the distance at which an object can be recognized 3 A restricted eld of vision may be referred to as tunnel vision pinhole vision or tubular vision 4 Educational definitions of blindness focus primarily on the student s inability to use vision as an avenue for learning and are directed at ensuring an appropriate instructional program A Partial sight low vision 1 A person who is partially sighted has a visual acuity greater than 20200 but not greater than 2070 in the best eye after correction 2 The eld of education distinguishes between blindness and partial sight in order to determine the level and extent of support services required by students B Students who are partially sighted are able to use vision as a primary source of learning C Classi cationVision loss can be classified according to the anatomical site of the problem Anatomical disorders include loss of the refractive structures of the eye muscle anomalies in the visual system and problems of the receptive structures of the eye 1 Refractive eye problemsThese problems are the most common and include a Hyperopia farsightedness Which occurs When the eyeball is excessively short forcing light rays to focus behind the retina b Myopia nearsightedness which occurs when the eyeball is excessively long forcing light rays to focus in front of the retina c Astigmatism which occurs when the surface of the cornea is uneven or the lens is structurally defective preventing light rays from converging at one point d Cataracts which occur when the lens becomes opaque resulting in severely distorted vision or total blindness Muscle disordersThese disorders of the vision system occur when the major muscles within the eye are weakened in function resulting in a loss of control and an inability to maintain tension Nystagmus is a continuous involuntary rapid movement of the eyeballs a Strabismus occurs when the muscles of the eye are unable to pull equally and the eyes cannot focus together on the same object i Esotropia occurs when the eyes are pulled inward toward the nose Exotropia occurs when the eyes are pulled out toward the ears b Amblyopia is the loss of vision due to the imbalance of the eye muscles Receptive eye problems Vision loss that is associated with the receptive structures of the eye occurs when there is degeneration of or damage to the retina and optic nerve Optic atrophy is a degenerative disease that results from deteriorating nerve bers connecting the retina to the brain a Retinitis pigmentosa is a hereditary condition resulting from a break in the choroid b Retinal detachment occurs when the retina is separated from the choroid and the sclera c Retinopathy of prematurity ROP occurs when premature infants are administered too much oxygen resulting in the formation of scar tissue behind the lens III Prevalence At least 20 of the general population experiences visual problems but most of these defects can be corrected to a level where learning is not impeded A It is estimated that 3 of the population has a signi cant vision loss About 5 of American children have a serious eye disorder The severity of vision loss is related to age with nearly 50 of people over the age of 65 experiencing a signi cant vision loss if cataracts are included D Approximately 26113 of schoolage children and youth with vision loss receive specialized services in the public schools 2006 OW Causation amp Characteristics Genetic Disorders A number of genetic conditions may result in vision loss including albinism retinitis pigmentosa optic atrophy cataracts severe myopia associated with retinal detachment lesions of the cornea abnormalities of the iris microphthahnia anophthahnia and buphthalmos glaucoma A Acquired Disorders Several factors prior to during or after birth may result in acquired vision loss including drugs radiation prenatal infections diseases prolonged use of oxygen with premature infants accidents tumors in ammations and degeneration The leading cause of blindness worldwide is vitamin A deficiency xerophthahnia Cortical visual impairment is a leading cause of acquired blindness and involves damage to the occipital lobes and or the visual pathway to the brain The most common cause of preventable blindness is the infectious disease trachoma associated with living conditions and hygiene within a community The most common vision problems in adults especially over age 65 are caused by macular degeneration B CHARACTERISTICS Age of onset is signi cant in relation to an individual s development If sight is lost after the age of five it is possible to retain some visual frame of reference Total blindness that occurs prior to age five has the greatest negative in uence on overall functioning Intelligence The intellectual development of children with vision loss differs from that of their sighted peers in some areas of intelligence ranging from understanding spatial concepts to a general knowledge of the world Speech and Language SkillsChildren with vision loss are at a distinct disadvantage in developing speech and language because they are unable to visually associate words with objects Their speech may be slower in development but once speech is learned it is typically uent Academic Achievement The educational achievement of children with vision loss may be signi cantly delayed as a result of excessive school absences due to the need for eye surgery or treatment as well as years of failure in programs that did not meet students specialized needs Social Development A number of factors may lead to greater social dif culties for individuals with vision loss A sighted person may misinterpret what is said by a person with a vision loss because visual cues may not be consistent with speech People with vision loss often are excluded automatically from social activities because they cannot see This only reinforces the mistaken idea that they do not want to participate and would not enjoy these activities Orientation and Mobility V Vision loss may affect ne motor coordination and interfere with the ability to manipulate objects PerceptualMotor Development People who are blind do not perform as well as sighted people on complex tasks of perception including fOI H l identi cation spatial relations and perceptualmotor integration However skills in discriminating texture weight and sound are comparable to those of individuals with sight Educational Supports and Services Mobility Training amp Daily Living Skills Educational programs for students with vision loss should include mobility training and the acquisition of daily living skills Independent travel development in children with low vision can be hindered if interventions are not targeted to rectify the following problems Issues with glare Lighting changes Drop offs at stairs and curbs Street crossings Changes in ground surface Busy areas Obstacles in the environment Inclement weather Orientation and Signage Guide dogs or devices such as the Mowat Sensor Laser cane and Sonicguide allow individuals with vision loss to travel with greater independence Instructional Content Mobility training and daily living skills are components of an educational program that must also include an academic curriculum Oral expression can be expanded to include handwriting as a means of communication39 social and instructional language skills can open doors to math and reading and reading can expand the overall knowledge base Various aids are available to help individuals with vision loss capitalize on any remaining vision organize topics and tasks to be learned and engage with more complex mathematical concepts rao rho CLO crm Communication MediaCommunication media can facilitate leaming for people with vision loss Through optical aids in conjunction with auditory and tactile stimuli individuals with vision loss can better develop an understanding of themselves and the world around them Tactile media include the raised line braille system and the Optacon Scanner In IDEA Congress mandated that schools make provisions for instruction in braille and for the use of braille unless determined as not appropriate by the IEP team Specialized auditory media include the Kurzweil Personal Readers microcomputers with voice output talking calculators talking book machines compact disc players and audiotape recorders Other communication media includes specialized library and newspaper services Personal Digital Assistants PDA and closed circuit television CCTV VI Healthcare and Social Services Health CareInitial screenings for vision loss are usually based on the individual s visual acuity Visual acuity is assessed through the use of the Snellen test which is used primarily as a screening test to measure central distance vision Prevention Strategies for prevention of vision loss include genetic screening and counseling appropriate prenatal care and early developmental assessment Treatment The nature of the treatment depends on the type and severity of vision loss The development of optical aids including corrective glasses and contact lenses has improved many individuals access to the visual world a Medical treatment may range from complex surgical procedures associated with corneal transplants to atropinization which is the fairly simple process of washing out the eye with the alkaloid drug atropine Social Services Social services include infant stimulation programs and family counseling to address preparation for employment and independent living and human sexuality and other relationships a Other community services may include specialized library and newspaper services auditory pedestrian signals braille menus and community services that use synthesized speech in automatic teller and ticket machines


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